Surgical management of a brain abscess due to plant foreign body in a dog

Abstract

Background: Intracranial abscesses as a result of grass awn migration have been rarely described in the veterinary literature. The identification of their radiological features is mandatory for proper diagnosis. As occurs with abscesses in other organs, surgical drainage and directed antibiotic therapy should be considered the treatment of choice. Case Description: A clinical case of a Great Dane dog with forebrain signs and magnetic resonance imaging and computed tomography findings compatible with intracranial abscess associated with inflammatory changes in orbital musculature is described. An exploratory rostro-tentorial craniotomy with durotomy was performed, allowing the drainage of purulent content and the extraction of a plant foreign body from the cerebral parenchyma. Antibiotic treatment was instituted and the patient was discharged without recurrence of neurological deficits other than quarterly seizures. Six months later, revision magnetic resonance was performed, revealing the resolution of the intracranial lesion and the normalization of the extracranial tissues. Conclusion: This is the first case in veterinary literature in which a grass awn has been surgically extracted from the brain of a dog with long-term outcome described. Observed changes in the extracranial musculature were fundamental to establish the pre-surgical diagnosis of a migratory foreign body.

Recovery after inadvertent intramedullary microchip implantation at C1–C2 in a kitten

“…Abscess formation within the CNS is mostly described with foreign bodies of plant origin. 31 , 32 , 38 Sterile CNS foreign bodies like suture material, 30 cotton pledget 28 , 29 and bone wax 39 have been reported to cause late-onset clinical signs in humans due to granulomatous reactions that could potentially lead to complications in our cat in the future.…”

Intracerebral foreign body: A needle in a dog's brain

“…One study described an awn migration into the neurocranium through orbital musculature and caused abscess in the forebrain. 1 Surgical drainage and extraction of the plant was successful, and all the neurological signs (depressed mental status, spastic tetraparesis and ataxia, with pelvic limbs more affected) were resolved. Another type of foreign body is wood or stick that can penetrate into the skull and brain.…”

“…It is not uncommon that clinical signs develop some weeks to months following the entry of the foreign material into the patient's body. 1,2 In human medicine, the foreign bodies most commonly are various surgical objects, bullets, wood, nails, knives and even sewing needles. 3,4 Most of the patients are presented with signs such as headache, seizures.…”

“…Objects can enter into the skull through the skin, ear canal, conjunctiva, the nasal or oral cavity. It is not uncommon that clinical signs develop some weeks to months following the entry of the foreign material into the patient's body 1,2 . In human medicine, the foreign bodies most commonly are various surgical objects, bullets, wood, nails, knives and even sewing needles 3,4 .…”

“…In the veterinary literature, grass awn penetration into the brain is not uncommon. One study described an awn migration into the neurocranium through orbital musculature and caused abscess in the forebrain 1 . Surgical drainage and extraction of the plant was successful, and all the neurological signs (depressed mental status, spastic tetraparesis and ataxia, with pelvic limbs more affected) were resolved.…”